(Note: When this article first went live, I received 127 emails of complaint in the first 24
hours alone!!)

In every field of medicine we are seeing that increasingly psychiatric drugs are
replacing the care previously afforded by human contact - especially in the area of long
term elderly care who curiously are now being targeted for Ritalin prescriptions as an adjunct to
SSRI's for elderly depression.

However, for the anti-Ritalin movement to blame parenting for the changes in
children's behaviour that are labeled as "ADD/ADHD" is to ignore the sociological and cultural
phenomena that surround the family nexus. At the point of the manifestation of the ADD/ADHD
symptomology it is the responsible parent in our social nexus that takes their child to the
paediatrician, not vice-versa. It is at this level that the therapist needs to begin in order to
unravel the binds that the child and family are caught up in. To place sole responsibility onto the
parent is to enter into the cause and effect relationship of the diagnostic protocol and is as
negligent as the psychiatric terminology such as the DSM that promotes such notions as ADD and ADHD
in our culture in the first place.

As might well be expected, I support no notion that ADD or ADHD exists as anything other than a
sociological phenomena and I watch with interest as the psychiatric and drug industries continue
their search for the alchemical Holy Grail of psychopharmacology.

The major psychiatric texts all look to the usual area of causality - i.e. genetics. We see the
now standard invocation of the twin studies that attempt to show concordance as if there are enough
sets of deviant twins world wide to cover every psychiatric diagnostic category of the DSM. What we
don't see however is a single discussion of the conditions and standards of our current
education systems nor of the role models provided by our media. Also missing from these texts is
even the smallest allusion to cybernetic processes within interpersonal relationships. It seems that
these concepts might possibly be considered to be too complicated for our psychiatric staff.

Listed and discussed briefly here are the neuro-psychiatric findings from research into ADD/ADHD
from the biological perspective. If you are an NLPerson working in therapeutic change work with
clients you can be assured that your clients will already have read up on these 'facts' - you need
to know them if working with the family who has a member diagnosed with ADD.

Firstly let's look at what the initials mean.

ADD stands for Attention Deficit Disorder - this is the fidgety, socially failing child, who
[contextually] lacks attention and interest and is poorly motivated. He lacks the impulsivity of the
ADHD diagnosed child - Attention Deficit Hyperactivity Disorder - who has the same lack of attention
but is somewhat impulsive. Broadly speaking we can consider the 'disorders' to be the same in
origin. For a fuller description of these terms you may like to consider perusing that bible for the
insurance companies, the DSM iv which details the behaviours commonly associated with these
disorders.

Whilst food 'additives' are most commonly believed to be the causation of these behavioural
changes, there exists very little evidence that this is the case. This is something that has been
largely ignored by a sizable number of people who will be unaware of this and state that their
children's behaviour definitely changes if they eat the 'wrong' foods. However, if such a belief
permeating our cultural theology means that our children are likely to receive a better diet, then
long may such a belief persist.

From a neurological perspective, the "minimal brain damage" theory has been popularised. The
purported brain damage has been described as "minimal" owing to the lack of identified changes in
the brains of ADD/ADHD diagnosed children by structural scanning (i.e. via MRI and CT brain
scanning).

Functional scanning however did demonstrate decreased cerebral blood flow and metabolic rates in
the frontal lobe areas of children diagnosed with ADD/ADHD. Kaplan suggests that one possible
explanation of ADHD is that these children are not "adequately performing their inhibitory mechanism
on lower structures, an effect leading to disinhibition". No one has suggested however, just how
many of the neurobiological changes demonstrated by the ADD/ADHD group are in response to the
process of being scanned etc.

Despite the ongoing quest for the neurobiological basis of ADD/ADHD we cannot escape one
essential detail - ADD/ADHD diagnosed children show no signs or history of head/brain injury and
there is no increase of ADD/ADHD signs amongst the population of children that do suffer head/brain
injury. Hence the need for the 'soft signs' and 'minimal brain damage' theories.

Kaplan suggests that in families where the child has a diagnosis of ADHD co-existent with
a "conduct disorder" (i.e. he doesn't like someone and he let's them know it) there is an
observed increase in alcohol usage and personality disorders when compared to the general
population. Naturally, it is presupposed that this has a genetic causality. It is also suggested
that siblings of hyperactive children have twice the "risk" of manifesting hyperactivity and even
that "one sibling may predominantly have hyperactivity symptoms, and others may predominantly have
inattention symptoms[!!!]"

Kaplan goes on to state that children in institutions are "frequently overactive" and have "poor
attention spans." He tells us that: "These signs result from prolonged emotional deprivation, and
they disappear when deprivational factors are removed, such as through adoption or placement in a
foster home." However the experience of too many adoption and foster parents tells us otherwise. The
research into the phenomena now known as "attachment disorder" affecting children such as those seen
in the Romanian orphanages taken into loving foster/adoption homes, indicates that after a critical
period, changing the manifest negative behaviour of children reared in emotionally deprived
environments is notoriously difficult. Those wanting to know more about such occurrence's might like
to read the research of Martin H. Teicher et al at McLean Hospital in Belmont Mass., USA,
summarised in the
Scientific American, March 2002.

Another model seeking to explain the phenomena (remember, sociological perspectives are all too
often missed or ignored by mainstream psychiatry and neurology) is that of the neurotransmitter
hypothesis - otherwise known as the chemical imbalance theory.

It is the area of the brain known as locus ceruleus that plays an important role in paying
attention. The brain cells that make up this area are mostly noradrenergic
(noradrenaline/norepinephrine) neurons. A complicated theory suggests that a feedback
mechanism involving the peripheral noradrenergic nervous system affects the function of this brain
region but this is no little relevance to NLPers. Phew! The major influencing factor on the
biochemical hypothesis is the observation that stimulant drugs appear to calm down the behaviour of
children diagnosed with ADD/ADHD. The stimulants such as Methylphenidate (Ritalin), methamphetamine
(Dexedrine, 'Speed'), Pemoline (Cylert) and Gettuff Hydrochloride (Sitdownandbehavenow) are most
commonly used. These drugs stimulate both dopamine (which is why recreational users take them too)
and noradrenaline (norepinephrine) leading to the assertion that these neurotransmitters are
involved in some way in the processes of ADD/ADHD. To suggest that these drugs "correct the chemical
imbalance" is woefully naive and simplistic but tragically seems to satisfy most people's need for
basic understanding of the issues.

It is often stated that ADD/ADHD diagnosed children have a polarity response to stimulant drugs -
i.e. they affect people with "ADD/ADHD" in differently to the way they affect the "normal"
population. This is a misconception that has not been supported by research and these drugs affect
most people equally or in at least the same way as alcohol or any drug will affect people equally
(according to individual characteristics, dose, set, setting etc). The diagnosis of ADD/ADHD does
not necessarily predict a polarity response at all and in the therapeutic doses given (milligram per
kilogram) will exert a similar effects across recipient groups. This is partly why the authorities
are trying to play down or even ignore the "Kiddie Cocaine" phenomena that demonstrates children's
great adaptation response to forcible medication - i.e. they have an interesting tendency to grind
it into a powder and sell it to 'normals' in the playground at a dollar a pop, thus rendering
everyone under the same behavioural control - some willingly, the others by attrition.

The issue of Ritalin being an addictive stimulant like "Speed" has been in the news recently, but
unfortunately under the guise of the appalling Elizabeth Wurtzel's book about her addiction to the
drug after she was prescribed Ritalin to compliment the Prozac she was prescribed to treat her
"atypical depression" - catalogued ad nauseam in "Prozac Nation. Young and Depressed in
America" - a thrilling read indeed.